Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Radiology, Faculty of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
J Med Virol. 2021 Sep;93(9):5425-5431. doi: 10.1002/jmv.27060. Epub 2021 May 13.
A rapid outbreak of novel coronavirus, coronavirus disease-2019 (COVID-19), has made it a global pandemic. This study focused on the possible association between lymphopenia and computed tomography (CT) scan features and COVID-19 patient mortality. The clinical data of 596 COVID-19 patients were collected from February 2020 to September 2020. The patients' serological survey and CT scan features were retrospectively explored. The median age of the patients was 56.7 ± 16.4 years old. Lung involvement was more than 50% in 214 COVID-19 patients (35.9%). The average blood lymphocyte percentage was 20.35 ± 10.16 (normal range, 20%-50%). Although the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were high in more than 80% of COVID-19 patients; CRP, ESR, and platelet-to-lymphocyte ratio (PLR) may not indicate the in-hospital mortality of COVID-19. Patients with severe lung involvement and lymphopenia were found to be significantly associated with increased odds of death (odds ratio, 9.24; 95% confidence interval, 4.32-19.78). These results indicated that lymphopenia < 20% along with pulmonary involvement >50% impose a multiplicative effect on the risk of mortality. The in-hospital mortality rate of this group was significantly higher than other COVID-19 hospitalized cases. Furthermore, they meaningfully experienced a prolonged stay in the hospital (p = .00). Lymphocyte count less than 20% and chest CT scan findings with more than 50% involvement might be related to the patient's mortality. These could act as laboratory and clinical indicators of disease severity, mortality, and outcome.
一种新型冠状病毒（coronavirus disease-2019，COVID-19）的迅速爆发已使其成为全球大流行疾病。本研究旨在探讨淋巴细胞减少与计算机断层扫描（CT）特征与 COVID-19 患者死亡率之间的可能关联。我们收集了 2020 年 2 月至 2020 年 9 月期间 596 名 COVID-19 患者的临床数据，回顾性研究了患者的血清学调查和 CT 扫描特征。患者的中位年龄为 56.7 ± 16.4 岁。214 名 COVID-19 患者的肺部受累超过 50%（35.9%）。平均血液淋巴细胞百分比为 20.35 ± 10.16（正常范围为 20%-50%）。尽管超过 80%的 COVID-19 患者的 C 反应蛋白（CRP）和红细胞沉降率（ESR）水平较高；但 CRP、ESR 和血小板与淋巴细胞比值（PLR）可能无法指示 COVID-19 的住院死亡率。严重肺部受累和淋巴细胞减少的患者发生死亡的几率显著增加（比值比，9.24；95%置信区间，4.32-19.78）。这些结果表明，淋巴细胞减少<20%同时肺部受累>50%会使死亡率的风险呈倍数增加。该组的住院死亡率明显高于其他 COVID-19 住院病例。此外，他们在医院的住院时间明显延长（p=0.00）。淋巴细胞计数<20%和胸部 CT 扫描结果>50%受累可能与患者的死亡率有关。这些可以作为疾病严重程度、死亡率和预后的实验室和临床指标。
